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Published on: January 28, 2019
Impact of rotavirus vaccine introduction in Abidjan, Côte d'Ivoire
Alice Britoh Mlan1, Rachel M Burke2, Hamidou Koné3
1Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire.
Insights
Côte d'Ivoire
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Public Health Surveillance
Background:
- Rotavirus is a leading cause of severe gastroenteritis in children globally.
- Côte d'Ivoire introduced the rotavirus vaccine in March 2017.
- Effective surveillance is crucial for monitoring vaccine impact.
Purpose of the Study:
- To evaluate the impact of rotavirus vaccine introduction on pediatric gastroenteritis hospitalizations in Abidjan, Côte d'Ivoire.
- To compare rotavirus prevalence, age distribution, and severity before and after vaccine implementation.
Main Methods:
- Sentinel surveillance data from 2014 to mid-2019 were analyzed.
- Poisson regression was used to assess changes in rotavirus prevalence.
- Mann-Whitney U test compared age distribution and severity scores.
Main Results:
- Rotavirus-positive hospital admissions decreased by 51% post-vaccine introduction.
- The median age of children hospitalized with rotavirus increased significantly.
- A decrease in the median severity score was observed.
Conclusions:
- Rotavirus vaccine introduction in Abidjan was associated with a significant reduction in hospitalizations.
- The findings suggest a positive impact of the vaccine on pediatric gastroenteritis.
- The study highlights the importance of vaccination programs in disease control.
Abstract:
Côte d'Ivoire introduced rotavirus vaccine in March 2017. Rotavirus surveillance is conducted at Centre Hospitalier Universitaire de Yopougon in Abidjan, the capital city. Children <5 years of age are enrolled in rotavirus surveillance if admitted to the hospital with acute gastroenteritis. We used sentinel surveillance data from 2014 through mid-2019 to compare trends in rotavirus pediatric gastroenteritis hospitalizations before and after rotavirus vaccine introduction. We used Poisson regression to analyze changes in rotavirus prevalence, adjusting for calendar month and accounting for total monthly admissions; January 2014 - December 2016 was considered "pre-vaccine," and January 2017 - June 2019 was considered "post-vaccine." Age distribution and severity were compared between periods using the Mann-Whitney U test. Rotavirus-positive admissions declined 51% (95% CI: 28%-67%), from 31.5% pre-vaccine to 14.9% afterward. The median age of rotavirus-positive children increased from 7 months (interquartile range [IQR]: 5-11) in the pre-vaccine period to 11 months (IQR: 7-18, p = .005) in the post-vaccine period. The median severity score decreased from 11 to 9 (p = .008) among all children, and from 12 pre- to 10.5 post-vaccine (p = .35) among rotavirus-positive children. Our findings suggest that rotavirus vaccine introduction contributed to reduced rotavirus hospitalization in Abidjan and possibly more broadly.
